Health Care Costs Depend on Your Doctor — Healthshare

Health Care Costs Depend on Your Doctor

You’re probably aware that going outside of a plan’s network of providers means the patient pays a larger share of the cost, but the difference between physician fees may really shock you.

Outrageous Medical Pricing Catches Patients Unaware

America’s Health Insurance Plans has brought this to light.  They presented data collected by Dyckman & Associates to reveal doctors that don’t participate in health insurance networks actually charge patients up to 10 times more, or in some cases up to almost 100 times more, than what Medicare reimburses other doctors for the same work in the same region of the country.

Medical Prices Vary across 30 States Surveyed

Across the 30 biggest states, doctors were seen to charge surprisingly high prices for a wide range of different procedures and treatments.  While there’s been a lot of attention paid to how much insurance companies pay for health care claims, less attention has been paid to what patients are paying.  That may be, in part, due to the fact that patients rarely compare prices.  One way to do that is through the Healthcare Blue Book website.

If you think that’s a lot of trouble, consider this.  In New York, a doctor billed a patient 62 times more than the Medicare approved fee for lumbar spinal infusion.  That was just $1,867, according to Medicare.  The doctor’s actual fee was $115,625. And, the report uncovered similar gouging in all of the 30 states where records were surveyed.

Since you can’t count on policymakers to investigate and take action on this problem, it’s in your hands.  When looking for health plans, pay close attention to provider networks.  Confirm that the doctors you need will be covered at the lowest rates available.  You may have to check the plan’s provider network again in coming years because these networks can change.

I encourage everyone to take personal responsibility for their healthcare, including asking for prices up front.  Comparing prices is the smart way to protect yourself from price gouging, and the more people comparing prices, the more pressure health care providers will feel to compete on price, and the less we’ll all pay.


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